Why is a claim declined?

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The two most common reasons for declining a claim are:

  • The claimant doesn't meet the definition - to have a valid claim under a critical illness contract, you must be suffering with one of the defined critical illnesses covered by your policy. You may also have to meet certain criteria.
  • Misrepresentation of information at the application stage - if you haven’t completed the application form correctly and we become aware of medical information that would have affected the original underwriting decision, we may not be able to pay a claim.